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HIV Behavioural Surveillance Survey in Kajo Keji County

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HIV Behavioural Surveillance Survey in Kajo Keji County id18844656 pdfMachine by Broadgun Software - a great PDF writer! - a great PDF creator! - http://www.pdfmachine.com http://www.broadgun.com HIV Behavioural Surveillance Survey in Kajo Keji County, Central Equatoria State, Southern Sudan IGAD - UNHCR August 2010 ACKNOWLEDGEMENTS The HIV Behavioral Surveillance Survey (BSS) in Kajo Keji County in Central Equatoria State, Southern Sudan was a collaborative effort between many individuals and organizations. The United Nations High Commissioner for Refugees (UNHCR), Canadian International development Agency (CIDA), World Bank (WB) and Inter-governmental Authority on Development (IGAD) supported the project financially and technically. The Ministry of Health, the Southern Sudan AIDS Commission, Central Equitoria State AIDS Commission and the Southern Sudan Commission for Census, Statistics and Evaluation, played a critical role in the formulation, design and implementation of the survey. The following people deserve special mention for the roles they played in supporting the implementation of this survey: Dr. Lul Riek, Ministry of Health; Dr. Ayat Jervase, Ministry of Health; Ms. Viana Kakuli Aggrey, Southern Sudan AIDS Commission; Mr. Joel Dumba-Crispo, Central Equitoria State AIDS Commission; Mr. Eliaba Yona Damundu and Mr. Julius Sebit, Southern Sudan Centre for Census, Statistics and Evaluation. The team of 27 field staff of enumerators, field guides, drivers, and data entry clerks worked tirelessly to ensure the success of the survey even in a physically challenging environment and under stressful conditions. Dr. Paul Spiegel, Ms. Marian Schilperoord, Dr. Patterson Njogu, Ms. Angela Kitonga and Ms. Sylvia Alison of UNHCR most zealously and relentlessly supported the implementation of this project. Ms. Grace Mugwe and Mr. Domity Akoi assisted in arranging logistical support to the survey in Kajo Keji. The entire UNHCR Southern Sudan office gave logistical and administrative assistance to the project, and particular thanks go to Ms. Farheen Khan for the gallant role she played in ensuring efficient and effective coordination of all the survey activities. All the respondents also need recognition for their willingness to open up and share their lived experiences, thoughts and ideas with the survey team. We acknowledge and appreciate Professor Charles Nzioka, the principal Investigator for the gallant role he played in ensuring rapid data collection, analysis and reporting in extremely difficult circumstances. ii ABBREVIATIONS AND ACRONYMS AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Clinic BSS Behavioral Surveillance Survey CPA Comprehensive Peace Agreement CIDA Canadian International Development Agency GONU Government of National Unity GOSS Government of Southern Sudan HCT HIV/AIDS Counseling and Testing HIV Human Immunodeficiency Virus HIV/AIDS Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome IDPs Internally Displaced Persons IGAD Inter-Governmental Authority on Development IRAPP IGAD Regional HIV/AIDS Partnership Program MARP Most-at-Risk Population MOH Ministry of Health MSM Men who have Sex with Men NAC National AIDS Commission NSACC New Sudan AIDS Control Council PMCTC Prevention from Mother to Child Transmission SSAC Southern Sudan AIDS Commission SSHASF Southern Sudan HIV/AIDS Strategic Framework SPSS Statistical Package for Social Sciences SPLA Sudan People’s Liberation Army SPLM Sudan People’s Liberation Movement STI Sexually Transmitted Infection UNAIDS United Nations Joint Program on AIDS UNHCR United Nations High Commissioner for Refugees VCT Voluntary Counseling and Testing WHO World Health Organization iii TABLE OF CONTENTS ACKNOWLEDGEMENTS .......................................................................................................... ii ABBREVIATIONS AND ACRONYMS ........................................................................................ iii LIST OF FIGURES ................................................................................................................... vi EXECUTIVE SUMMARY ......................................................................................................... viii SUMMARY OF KEY KAJO KEJI BSS INDICATORS ......................................................................xii CHAPTER 1: INTRODUCTION ................................................................................................ 15 Background information ......................................................................................................................... 15 Objectives of the Behavioral Surveillance Survey ................................................................................... 15 South Sudan: Geo-Political Context ........................................................................................................ 16 HIV and AIDS Situation in South Sudan ................................................................................................... 16 Southern Sudan’s Response to HIV and AIDS ......................................................................................... 18 CHAPTER 2: SURVEY METHODOLOGY ................................................................................... 20 Survey design .......................................................................................................................................... 20 Study Area: Description .......................................................................................................................... 20 Sampling methodology ........................................................................................................................... 22 Sample Size Determination ..................................................................................................................... 22 Study Instrument .................................................................................................................................... 23 Ethical Considerations ............................................................................................................................. 26 Data Management and Processing ......................................................................................................... 27 CHAPTER 3: RESULTS ........................................................................................................... 28 Socio-Demographic Characteristics ........................................................................................................ 28 Income .................................................................................................................................................... 29 Displacement and Mobility ..................................................................................................................... 30 Sexual Behavior ....................................................................................................................................... 32 Regular Sexual Partners ......................................................................... 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Non Regular Partnership ..................................................................................................................... 36 Transactional Sex ................................................................................................................................ 39 Forced sex ........................................................................................................................................... 40 Anal Sex ............................................................................................................................................... 40 Co-Factors to HIV Transmission .............................................................................................................. 40 Sexually Transmitted Infections (STI) .................................................................................................. 40 Circumcision ........................................................................................................................................ 42 Alcohol and Substance Abuse ............................................................................................................. 42 Military Activity ................................................................................................................................... 43 HIV Knowledge, Opinions and Attitudes ................................................................................................. 44 Exposure and Access to Interventions .................................................................................................... 47 Sources of Information on HIV/AIDS................................................................................................... 47 iv HIV Counseling and Testing (HCT) ....................................................................................................... 49 Access to Services ............................................................................................................................... 50 CHAPTER 4: DISCUSSION AND CONCLUSION ........................................................................ 52 Discussion................................................................................................................................................ 52 Conclusion ..............................................................................................................................................
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